Service Dog Academy Puppy Application
Our goal is to place each of our puppies in a well suited home where the puppy will meet the owner’s expectations and the owners will provide a home that matches the puppy’s personality and takes advantage of the puppy’s talents and skills. To help with this process, we ask that you complete the following questionnaire to formalize your interest in one of our puppies. Acceptance of this form by Service Dog Academy does not guarantee you a puppy but will enable you to be considered for one of our pups. Return your completed questionnaire to by clicking on the submit button at the bottom of this form. You may also print off the form and send it to 1632 Lakeview Dr. Waterloo, IL 62298.
Name *
Spouse/Partner Name
Address *
City, State, Zip *
Home Phone *
Work Phone
Cell Phone *
Email Address *
Employer *
If you are employed, please describe your job and your work environment.
Are you a student? If so please provide the school and grade level.
Is this dog for a child? *
Spouse/Partner Employer
Please list all members of your household with ages and adult’s occupations
Do you or anyone in your household have allergies to dogs? If so, who? *
Please list your activities, sports, and hobbies. *
Please describe your typical day. *
How would you describe your energy level? *
How did you hear about us *
Why do you want a Service Dog Academy puppy? *
Why is a Service Dog Academy puppy right for you? *
Do you have a strong preference for one sex or the other? *
Why do you have a preference for one sex over another?
What type of dog are you looking for? *
If you want a service dog, what are your disabilities?
If you want a service dog, HOW OFTEN does your disability affect your life? Ex: 2 times weekly migraines make driving difficult
If you want a service dog, how does your disability affect your life?
If this dog is to be trained as a service dog for a school aged child, do you plan on the dog attending school with the child? If so, when? Have you discussed this with teachers or school administrators? If so, what was their response? *
Have you owned a service dog before?
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If you want a service dog, is your family supportive of your desire to have a service dog? If no, please explain.
If you want a service dog, do you have any concerns regarding owning a service dog?
If you want a service dog, with what organization will you be doing your task training?
If you want a service dog, with what organization will you be doing your puppy training, socialization and public access training with?
If you are training for service work, are you interested in purchasing our online video program on puppy socialization and puppy obedience training currently scheduled for release in 2017?
Clear selection
If you are purchasing this puppy as a pet, do you understand that you cannot breed it during its lifetime?
Clear selection
How would you describe the personality or specific traits you are looking for in your new dog? Do you want a couch potato, an active dog, a very active dog, etc? (Please be specific about energy level, drives, confidence, dominance/submission, independent, professional cuddler, appearance and anything else that is important to you in your dog.)
Are you on any other breeders’ puppy lists? If yes, who? *
Do you own/rent a home/condo/apartment? *
Do you have a fully fenced yard? Is it dog proof? What kind of fencing? How tall? *
Do you ever plan on leaving your dog in your yard unattended? *
Do you or anyone living in your household smoke? *
Where will your puppy spend most of his/her day?
Once grown, where/how will your dog spend most of his/her day?
Where will your puppy/dog spend his nights? (e.g., crated in the bedroom, alone in kitchen, in garage?)
For what periods of a normal day will your dog be left alone?
Will you be able to spend more time with the puppy when it first comes into your home? What arrangements have or must you make to do this?
We require all buyers to attend a Puppy Kindergarten class that includes free play among the puppies. Where will you and your puppy attend Puppy Kindergarten? *
Please tell us a little about the other pets you have now. What kind are they? What are their sexes and ages? For dogs, list your dogs’ breed, registered names and titles.
Please tell us a little about your past dogs. What breed were they? List your dogs registered names and titles.
If any of your dogs have been lost or died, please explain the circumstances
Have you ever rehomed a pet in your household? If so, please explain why. *
Keeping a dog is not an inexpensive venture, between quality food, veterinary care, and training. Are you confident that you know how much this dog will cost you to maintain and that you have the resources to do so?
Are you willing to wait until your pup is over 18 months of age and, if female, has had at least one season, before spaying or neutering? *
How do you plan on exercising your dog? How many times per week do you plan on exercising your dog? *
Please provide 2 names, addresses and phone numbers of people who could verify your qualifications and lifestyle-- such as the breeders of your present dogs, dog trainers, training partners, friends, and neighbors. We strongly prefer email contact so please try to get correct email addresses. Missing email addresses will delay processing of your application. If you have pets, your last reference must be your veterinarian.
Do you understand that you are not guaranteed a dog just by submitting this application? *
Do you understand that your deposit is 100% non refundable unless we do not have a dog for you? *
Do you understand that you will not be placed on the list to receive a dog until your $500 non refundable deposit check is received by Mary McNeight at Service Dog Academy, 1632 Lakeview Drive, Waterloo IL 62298 *
Do you understand that full payment for the puppy is required by the end of their 6th week of life and if you do not pay the entire amount by then you will forfeit your spot in line for a puppy and lose your entire deposit? *
Do you have any further comments?
Are there any special considerations we should be aware of?
Electronically Signed On: *
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